Updated: Sep 21, 2018
by David Hallberg
This week we move on to our third and final step in tuning your Millennium chart servers: tuning the Windows operating system (OS) on each server. In step 1, you determined which of your chart servers was the fastest and copied that server’s configuration to the other servers. In step 2, you tuned your Oracle database tables. Once you complete this last part of our holistic tuning approach, you can expect the process time of your chart servers to be less than half a second per page.
Tuning of the OS running chart servers should start with Cerner. A document on Cerner Millennium System Settings (CMSS) for Windows is available from Cerner Support. The document has about 15 pages and contains a couple of key items that relate to our topic: 1) Pay attention to the effect that anti-virus scanning software has on the solution, and 2) be wary of the recommendation to run a defragmentation tool at least monthly. I recommend that you defragment the chart servers every day.
Many freeware and shareware solutions are available to defragment your servers. I enjoy using Defraggler from Piriform (www.piriform.com/defraggler). It has a native 64-bit client but runs on a 32-bit OS as well. Diskeeper from www.diskeeper.com is another excellent solution if you have the operational budget for it. For any of you running VMS, Diskeeper has great VMS defragmentation tools as well as I/O analysis tools.
A lot of people are documenting how they tune Windows. Doing a search on Google for “XP performance tweaks” returns 8.5 million results, “2003 performance tweaks” returns 2.6 million, and “2000 performance tweaks” returns nearly 4.7 million. Of the many sites that have excellent information on tuning the OS, I have a couple that I keep going back to:
PC Pitstop (www.pcpitstop.com) will run an audit on your server or PC and show you where you have potential performance and configuration issues. If you want to have the tool do the registry changes for you, there is a fee.
SpeedGuide.net (www.speedguide.net/index.php) has a lot of topics. If you choose the Broadband option at the top left of the page and then select Registry Tweaks, you will find a wealth of information on tuning the Microsoft TCP/IP stack for optimal performance.
Microsoft has excellent documentation at www.microsoft.com. Once there, search for “XP performance tuning” or “2003 performance tuning.” You will have to read through a lot of documents to determine which pieces you want to apply to your OS. That’s why I prefer PC Pitstop and SpeedGuide.net. I have found that by using them, I can quickly get the most from my OS.
My final piece of advice is to turn off the following two services, no matter what version of Windows you’re running:
ComputerBrowser was designed for Windows 95 PCs to act as the WINS server for DOS and Windows PCs. It is very chatty and actually quite a security hole. There is no need for this to run on any chart server.
Themes was designed to make the chart server have a graphically rich (pretty) view of the OS. I want chart servers to be fast, consistent and reliable. I do not need them to be pretty.
Prognosis: With apologies to the ′60s rock band The Byrds, I would encourage you “tune, tune, tune, there is a season, tune, tune, tune, and a time for every purpose….” The season is now and the purpose is to dramatically improve the overall responsiveness of the chart prints for clinicians.